Alloimmune

I had visited this place, this stifling humid ultrasound room, a thousand times in my fears. But now it was real, and I had a choice to make. All the grinning, stupid hope I had embraced, the idea that this was a walk of faith I could use to teach others, rose up as a dark maroon flush in my chest. Hubris. The ancient Greek kind.

The perinatologist didn't want to look at me. He felt he had failed, although none of it was his fault. He avoided my gaze in the hallway for months afterwards. He had to tell me the truth. One reality: Tomorrow we go to an OR, and he could try his best, put a needle through my uterus and deliver life-saving blood to the baby who languished inside. But an immense pool of blood had collected between the layers of amnion and chorion after my hemorrhage; the sac would most likely rupture and she would be born far too early, into death.

Alternate reality: We do nothing but wait, knowing that in a matter of days, her oxygen-starved heart, anemic due to my well-meaning but filicidal immune system, would swell and cease, and she would die into a silent birth.

“We will wait.”

For what? I was only running blindly away from the cold OR, another warm flood, the paralyzed finality, the darkness down that corridor. At least I could hold her a little longer this way.

I believe in God, do I believe in miracles? The week I learned I was pregnant a fourth time, it was the reading of the man born blind. One more baby, with a little help from perinatology. I dared to believe. Lord I believe, help my unbelief.

But how do miracles come to pass? Jesus spit in the mud and rubbed it on the man's face. What was it that transformed these things, banal and unclean, even disgusting, into a life-giving mystery?

Five days later I sit in a hospital bed, flushed, shivering from chills. A liter of other people's blood plasma, IVIG, runs into my veins. An idea so repellent, it just might work.

Tenuous in the shadows of the ultrasound, week by week, we are all astonished each time the waves flash on the screen and the calculator tells us that no intrauterine transfusion is needed.*

How then were your eyes opened?

Ksenia Olga RossPortland, Oregon

*Author's explanation: In other words, my medical team and I were astonished each week to find that despite having started this last ditch long-shot treatment (IVIG) and nearly dying of anemia, the treatment had worked so well my baby was able to generate her own red blood cells and did not require any intrauterine transfusions. The need for an intrauterine transfusion (IUT) is determined by doppler ultrasonography and calculating the multiples of median of the velocity of blood flow through the fetal middle cerebral artery. So every week there was a tense moment as they measured the waveforms and ran the calculator to determine if we would need to perform a risky IUT to save the baby. But we never did, something that is very unusual in these circumstances, nigh unto miraculous.